The Use of Touch in Psychedelic-Assisted Psychotherapy: A Tricky Topic

Dr. Signi Goldman 5:04

Yeah, I That reminds me. Like, one helpful phrase that I’ve said is, like, I’m happy if you shrug me off, because that means you’re tracking yourself accurately. Like, I’m usually, like, good. She’s paying attention to what she needs right now. Like, I say that kind of thing to the person, yeah, I think that’s good. There’s a piece with distance from the core that’s not in the video that we that Sandy, and I usually want to name, which is that, obviously there’s a lot of this is knowing your client, right? Like, some of what we modeled in that video was like being the most careful for people who are coming in with trauma, especially when you don’t know them yet and so on. If you’ve been working with someone for a while and you have a total different rapport with them, then obviously you’re going to be able to lean into touching them more spontaneously and all that, because you know them and you have that relationship. But when you are bringing someone in from the beginning, you want to model that you’re doing all those things carefully. So obviously with how many, how long you’ve known them makes a difference, and how casual or how like intuitive use you get with the touch while still being ethical, right? And you know that they know you well enough that they’ll communicate with you correctly about it, so you don’t have to worry that that’s not happening. So there’s there’s a piece there. I wanted to name and gender piece. Some of you, like those of you who are guys there, obviously, there’s this gender piece around trauma, in touch with women, that that is layered, that that goes for both genders, with both genders. It’s not a male therapist, female client thing. It goes with all the combinations. But there is, statistically, a lot more of that. And also it’s it is really it was surprising to me when I started doing this work. I think I would be interested, Sandy, in your take on this one too. How many people wanted my husband wanted contact from him as a team member in the room, a male. Yeah, that happened in retreat this Saturday with with my email. Yeah, it’s so don’t assume that, like sometimes the presence of a strong masculine touch is exactly actually what is being wanted, male, female or not in the client. And so I’ve had male and female clients where, when my husband was brought in with consent, they were really glad that it was like a safe male touch, specifically male. So I think what I want to emphasize is that I said this in the video, touch is a place where trauma, like touch is traumatic. People have been traumatized by touch, and also touch is in some ways, the ultimate healing thing, especially for very young parts, right? That where it touch was their original language, right then, you know? So as long as you are careful and ethical with how you use this, there are people who will. They would be better off having like a Rick or a Jake than a me, actually. So you we work with what we’ve got, but I just wanted to make sure. I just wanted to name that Sandy, I don’t know, what do you think on that, you

Dr. Sandy Newes 8:06

know, this, like we’ve all met, made, I believe, you know, he’s got a capacity to be very masculine, just energetically, and then to really, like, soften, and there is and so, you know, for for the men in the room, but also just energetically, to be aware of that, like, you know, that is profound, like, to be both like, have like, masculine energy and and again, that may or may not be specifically gendered, like, I have a lot of masculine energy myself. I have to work actually, with softness. And that’s kind of my sort of polarity balancing in my own life, is that, but it, but that, that balancing of like a gentle man, like, just don’t be, you know, don’t be afraid of that like to have both things be present. It’s, it’s, it’s really profoundly healing, not just for women, but for men too,

Dr. Signi Goldman 9:02

yeah, and this is getting a little more advanced than what we teach in level one. This is getting a little into level two. But we also like, if you are like, I’m a I’m a female therapist, but if I feel like male touch is needed, I will enroll myself as a male avatar, so to speak, for someone who’s in part of their process, or a imagined male other, and sometimes that is a huge thing. So just be aware to saying that I know that knowing the client well and knowing their history. And so when you’re doing consent around touch, you can name these gender pieces as part of that initial preparation conversation. And so what will happen with those of you who aren’t used to doing all this is that the awkwardness in this is not from the client. It’s going to come from you guys, because you’re not used to having these conversations like you’re going to feel like, Oh, I feel weird talking about this in the beginning, but you but it’s important, and it and it’s it does. It actually goes a long way to rapport like. A lot of times that first session, that session when you talk about touch, and you do all that like, like, it aligns, all of a sudden, you’ve got this amazing alliance after that, because they’re like, whoa, this person is tracking and also, like, I get to track myself this much, and they’re like, you know? So it can be a huge Alliance builder just having the very those initial conversations period. One of you said this on Saturday. I actually think it was you my email, but I’ve had, I’ve heard a lot, a lot, and this was in that sample session video I sent you guys, I don’t, I think, and we’re going to talk about that in a minute, but clients will say that the touch is, that is what tethers them to, not feeling like they’re spinning out into an out of control or or completely lost place. So what happens is, most clients want to have a psychedelic experience where they are in and experiencing non ordinary things, but they also know that there is a cord, a tether, you know, something back to reality that they can touch into, so that they can feel that both are happening and they’re not just like going to be gone somewhere, which is just more scary and and so a lot of times the touch, even if it’s just this, they will say afterwards, that kept me tethered to knowing that there was someone else with me and I wasn’t alone. Because when you go into an altered state, especially with these eye shades on, like, just so you can feel like, all of a sudden, you’re, you’re dying, or you’re, you’re drifting into this existentially scary place, which is the video you guys are going to watch next, by the way, is these fear moments and all that. But this is that a lot of times what they’ll do is they’re, they will associate the somatic contact with another human as Oh, I am still also in the room. I am still in this room. There’s a there is someone accompanying me on this journey, even though I’m the one that’s like seeing the things I am. I have company, and they name that a lot now that that could be touch anywhere, but a lot of times that is the touch. It’s not just touch. You can do that with your voice. I’ve interviewed a lot of clients about their experience and awful. A lot of people will also volunteer your voice was tethering me. And this is why you don’t want to just sit in silence for 40 minutes, because they will lose the they will lose you completely. This is why, in the in the next video, what? And I talked about like, don’t let them go too long without some sort of, are you doing? Are you doing great? Or where are you at that that they’ll, they’ll associate to the voice as something that tethering them, and then what they what their experience will turn into just a trip experience to I am having some sort of journey, and this person is tracking it with me, and I can dialog with this person, and that tethers. So where the somatic tether can get more powerful is if there’s if they’re afraid. So if they’re scared, and you’re saying, I’m here, you can do it with your voice. You get in closer and you’re like, I’m right here with you. You’re doing fine. You’re safe. I’m here. You can do with your voice. But a lot of people this, this is what feels like they’re tethered them back into in like, okay, because they the fear is usually associated with the fact that you’re, you’re, like, zooming out of control somehow, right? Or very various iterations of that kind of a thing. So this tether factor is also comes up with touch, voice and touch, your presence, period. But touch is a big part of your presence is it’s a more intense way of reminding them of your presence than than your voice, well. 

Dr. Sandy Newes 13:24

And I also wanted to add the same works in reverse, like you know, for me, I’ve done many, many, many cap sessions now, and in the beginning, it was a lot easier for me to be fully present because it was new. And the same thing goes in reverse. If you sit for too long silently and you are not connected to the client, either through your voice or through touch. It is also harder for you to be present, and so, you know, it’s for the client, but there is also something about keeping yourself tethered to them that I think is really valuable to just kind of be aware of.

Guest Speaker 2 14:01

Ma’am, yeah, I wanted to have a moment of like, you know, work a lot with young men at the VA and there’s a tendency for them to say, No, good, good. You know, it’s just there, there’s, I’m noticing a pattern that they are more likely to not even want to engage in a discussion about touch. And you know that could be because, you know, I’m who I am, but I’m but I’m wondering. You know, the way I left it is, hey, you know, I that’s totally fine. You know, if at some point you feel like you want to revisit this or renegotiate this, you know, I’m I’m, I’m here, I’m here for that. But it feel but it also feels like I It feels awkward for me to ask, Hey, you know, is this something you want to read? Visit, it feels like they should

Dr. Signi Goldman 15:02

be, yeah. And these are, these are vets, right? You’re working with, yeah. So this is kind of relevant for Rick and Jake’s population, too, in a way. This is and for a lot of us are going to see clients that, yeah, um, well, okay, so there’s a couple tricks. I mean, some of this may not be, actually what you’re asking, but one, one thing that’s actually interesting is that the word touch itself is kind of a tricky word, and a lot of times with guys, I don’t actually use the word touch, which is even though that’s how we’re teaching it to you guys. So I’m kind of glad you asked this, like with really stoic men, or I may say something like, I’m actually sometimes I’ll I’ll say, Hey, can I put my hand here for a second? This is in the preparation conversation. And I’ll say, can I put my hand here for a second on your shoulder? And I’ll say, sometimes, when we’re in the in the like, if you’re going through something that’s kind of intense, I may support you by doing this. Is that okay? So I’ve just said that without using the word touch, which sounds touchy feely, and also, I don’t know, so I don’t know these are, like subtle language things, but sometimes I just avoid touch and say, can I support you by putting my hand here? And it tends to be a little firmer and not like, you know, so I’ll say, support you this way instead. But this is, this gets into the one thing that this raises, that I was going to comment on already is none of you have asked the sort of question, the question, which is, what happens if they don’t want touch and then when they get in the session, they do, because they go into, say, a younger part. So you have this stoic guy, and he’s like, No, I’m not into that. And then under session, he turns into like a scared six year old boy who clearly is afraid and needs some sort of like reassurance or something, right? And then you know that that’s what you should do, but you’ve contracted not to different people in the psychedelic profession and Sandy and I’s kind of world fall differently on that. There are some people who will say, in that moment, I would kind of break the agreed contract. I teach not to because I just feel like you’re that’s a slippery slope. But there are people who disagree with me, who are really good people. So you can sit with your own sort of ethics around that. I think if you’re going to err on the side of caution, you would say, okay, so we won’t use touch, and then you just don’t use touch with those guys. And what will happen is, if in a session, it comes up that they could have used it and you didn’t do it, then in integration, you need to kind of like, bring it up and be like, hey, there was that one part where you were remembering being six years old and all that. And sometimes it’s really helpful, like, think about a six year old kid. It’s helpful to have support, like someone supporting you when you’re six, and so if it happens again, next time, what if we just did this or something? You know you can and you can do it that way. There are also ways of using touch without touching. So this is techniques for people who say they don’t want to be touched, which is not most of my clients, but probably is sounds like most of yours. So one of those is, like, literally, like, having a so you can do things. I have the blanket over them. You do this with consent. You say, Okay, we’re not touching you, but I’m gonna, I wish I had a video of this, because I use this one fairly often. You have the blanket that’s on them anyway. It helps to have two people. But even with one person, and without touching them, you just put really, really, you pull the blanket down to the sides of them, really hard. Basically, what you’re doing is putting pressure on their whole body with the blanket, and then you’re cueing them with your words to say that, like, I’m gonna this blanket is the holding of the whatever like, say it depends on what you’re working with. Say you’re working with the trauma memory of like, an abandonment. So you say, this is the blanket of of like, like, this blanket on you is, is the touch of me supporting you. You kind of plant that in verbally. So this may be getting a little more advanced for this course, but that’s a way that you can do it. And I can, I can maybe demo that at some point. And I do. I also use visualization where I will I will say, visualize that I’m holding your hand. The imagination can do a ton. So I’ll say, like, I’m not gonna hold your hand, but I’m sitting. I will usually get in. If you’re in the session and they need touch and you contracted not to do it, usually I scoot up a lot closer. So I’m talking to them from a few inches away. I get really close to them, like, face to face, in a way. So I’m talking really like, into their ears, and I’m saying, I want you to like, I want you to imagine that I’m that I’m holding your hand, or it could be the other, like, that your father is holding your hand, or that your mother is holding your hand. And so they know it’s imagination, but it gives them percent permission to visualize it. And then I will say, tell me when you feel it, because you know they have a huge capacity to manifest like a sense experience in the psychedelic state. And they will often say, Yeah, I feel it. And then what you’ve just done is allow them to feel touched without you actually literally touching them. So that works under. Under the medicine, it’s hard to explain in preparation, but I’ve done both those things, and then I haven’t violated my agreement that I wouldn’t touch them. And then usually, of course, in integration, you want to be like, hey, that whole thing happened. What do we want to do? That happens again? Kind

Dr. Sandy Newes 20:12

of thing. That’s also one of the advantages of doing a series. You know, I mentioned I typically don’t do less than three. And I think Yale has also moved in that direction with a new client. And so in a series, somebody might say that they don’t want touch in the beginning, and then, you know, then you can revisit it. Another thing that I do that is important to note is, again, it’s extremely different. Like, my phrase is their meat and fruit. Like, it’s just, it’s extremely different to just, do, you know, medicine alone, versus a bunch of preparation, you know, a solid relationship, you know, teaching and working with consent around touch prior to the medicine, than just suddenly putting hands on in the medicine when you don’t have all that. And the third piece is that, you know it’s also okay if you’re just like, I think, and this again, you know Signi said, whatever your kind of ethics are around this, and knowing your client is important. You know, if you have, you know, boundary violations around touch, you probably wouldn’t want to do this. But you know, if you’re sitting there and the person you know, just really, you’re like, I’m really feeling like, I, you know, really want to put my hand on your arm right now in order to blank, you know, or I’ll have somebody put their own hand on their heart, and then I’ll say, Is it okay with you if I put mine on top of yours, which is what I typically do the First time anyway, you know, if I think we could really, yeah, if you’re really transparent about it, you know, just know that you’re, you know, it’s, it’s a low, it’s loaded, right? Because it could also be really, really jarring and disruptive and not feel good to them. So it’s really, it’s loaded. But, you know,

Dr. Signi Goldman 21:58

there are yeah, those are, yeah, that both of those things you said reminded me of other things to say. So I’m glad one is never touch somebody just out of the blue, like, with no context or or interaction. Like, if I’m doing this, I always say, I’m going to put my hand on your chest and I look for the nod or, you know, because that that will scare people, and also, you could re traumatize something that you don’t even know that they’re carrying. So I think guys don’t need to hear that, but I didn’t. I hadn’t actually said it. But the thing Sandy said about letting them use their own hand is actually a really good in between technique, like I feel pressure my chest, put your own hand there, and then the step up between that and you touching it, is what she said, where they put their hand, and you put that your hand on top of their hand. So if you have someone in preparation who really doesn’t want touch, and they are like, I don’t want you to touch me. You can, I, you can introduce that as an option. Be like, well, if it you know, if something comes up, where we where I feel like a somatic intervention would help. What if I just keep, you, know, cue you or invite you to put your own hand on your chest, and then if I put mine on top of yours, how does that feel? And you can, you can, you can practice that in preparation too. That’s kind of a buffered version, but I forgot to that’s a good one. I’m glad you name that. And then you can also put weight on people with various objects that aren’t you. Like, we have a weighted stuffed animal thing in the clinic. Like, it’s kind of one of those, like, weighted blankets. It’s like a bean bag, you think, like, so, I mean, there you can get creative. I think one thing I just want to say again, because we have first responder and that clients in this cohort, is maybe avoid the word touch period. We just taught it to you as consent around touch, I would take touch out of your vocabulary because, like, think about the phrase I’m going to touch you. How loaded and weird that is for all of us. Right?

Guest Speaker 3 23:44

Trigger words like that for that particular community that they just don’t respond well to, I

Dr. Signi Goldman 23:50

bet, like the the idea of I’m going to touch you has been traumatized for most people. So when I when we talk it, this is actually something that we should say more often, and I might even change that video a little to include this, consent around touch is a term that like a therapist, a therapist term like we’re teaching you guys, hey, consent around touch. But really, I don’t talk to clients that way. I don’t necessarily say we’re going to talk about consent around touch. Now, I maybe, if it’s a woman or the vibe or the rapport is there, I will. But for someone who where that whole term is loaded, I would substitute talking about like somatic support language that way and avoid and then any if you’re working with anyone who has trauma, which is everyone, so be aware. But obviously there’s degrees of this, anything closer into the core of the body, is more vulnerable. So but holding the exception is holding hands is vulnerable because that’s associated with intimacy. But if you so, don’t hold hands unless that’s a really clearly contracted thing. Don’t just go to that necessarily, and unless intimacy is what is wanted in that way. But So touching here is less vulnerable than touching here, which is less vulnerable than touching here and here getting more vulnerable, right? And then abdomen is really vulnerable. So in general, like, especially someone who doesn’t want to touch, like a guy, like, I don’t know I, I’ll ask the guys here, but it’s usually something like supporting you by this, or just like putting a hand on your back or something like that. And then you might want to call it somatic support thoughts,

Guest Speaker 3 25:29

yeah, just sharing a personal experience from the the retreat in June, when I felt that I was about to come to a moment where I needed support made odd. And who was, who else was there? Was it Mike, I forget his name. Was it Dan, that’s Brian. Is Brian. Um, there. Brian came over and, you know, put about 30 pounds of pressure on my chest, and made on, grabbed my hand, and it was, it was something that I needed, that, right, there is something that I needed because, and I’ve had a lot of time to think about this, I think it has a lot to do with, you know, being a veteran, there’s that, like, kind of brotherhood, camaraderie, like I’m going to help you, you know, feeling and that really, that just That brought me right back to that feeling. And, you know, I do that a lot with my specifically my cops. Man, I really only see cops in my practice, and it’s huge for them. I can tell. And they expect hand

Dr. Signi Goldman 26:33

to hand, like, 

Guest Speaker 3 26:35

Oh, yeah. They expect it, yeah. So it’s, it’s, it’s kind of that, you know, when I think about doing this for for other men and even for some of the women that I see too, there’s a lot of there’s a lot, there’s a lot that’s there, I think there’s a big invitation, and especially if you introduce that early on to the connection you have with that client. To bring that up, like, Hey, I wonder if this would be helpful for you. If things get kind of dark or maybe challenging during your experience, that’s

Dr. Signi Goldman 27:02

a good way to say it. Like, what if we just yeah, like, so this is a good I love that you’re saying this because this is a great example of know your clients, like, know your population. And you guys do that already, and I know your population, so you would know how to language this better than I would with your kind of clients. And it’s also a reminder that there’s so much talk in our in the therapy community and in the broader culture about touch as trauma, right? We’re in this big moment in our culture around how we traumatize each other with touch, especially around sexual touch and so, right? So I think that we have collectively been overly scared off of it, like we’ve almost been discouraged from using it in the profession to their detriment of our clients. And I think we just said as a great example of like, the value of human touch if it’s done in an ethical and and intentionally held way. And I think a lot of therapists are have kind of been enculturated out of doing it, because it’s this idea that it’s always harmful when actually, often it’s it’s not at all. So, yeah, I’m very glad you shared that example of Brian and maydad, because you just said maydad was holding your hand in that, like, you know, vet to vet. Way, I know what I mean. I’m just using it as an example, but that, like, you know, comrade in arms kind of energy, not, not like, Oh, you poor thing, you need help. It’s more like, we’ve got other we’ve got each other as guys, kind of energy, I’m guessing I’m a woman, but I’m naming it from the outside. And you also said, Brian, put about 30 pounds of pressure in your chest, right? So, like, the example you described of when you were at retreat, and you said 30 pounds of pressure. Do you think it would have been different if Brian had just sort of rested his hand lightly?

Guest Speaker 3 28:51

Yeah, probably like

Dr. Signi Goldman 28:53

the pressure. Like, I know it’s hard to like, what do you think the difference made of having all the pressure, like, that amount of pressure, but that amount of force, it

Guest Speaker 3 29:00

was the way it was delivered. It was, it was so, it was so, um, like, it was like, direct pressure on an open wound. Like, I keep the red blood, I’m going to keep that bright red blood inside of you. It was, that’s what kind of, that’s what it kind of felt like. And that’s what just the pressure you do put on those wounds, you know, you know, you put 30 or more pounds of pressure on this one. And so I think if you could just come up and been like, Hey, sweetie man. But I don’t know, you never know. What does it do? Well,

Dr. Signi Goldman 29:34

no, but that’s, it’s a really, I appreciate the opportunity to ask you, because this is kind of what we’re saying about pressure matters and don’t be afraid of it, right? Be afraid of it. Sometimes what the body needs is like this very hard, intense response to be met. The teaching is that the intensity of what you’re carrying has to be matched by the intensity of the response. Or if there’s a mismatch, it won’t, it won’t work like. If you’re carrying something really intense and someone’s just like, like this, it’s like, it won’t right, you have to know that they can push back against it. So there’s a lot that could be said on this, and it’s, it’s super fascinating. And I encourage all of you guys to ask about it in your mentoring times, or just, we can talk more about it in future gatherings as things come up. I do want to take about five minutes real quick to talk about a few other content pieces, and then we want to move into kind of closing. So thanks for listening. Everyone. A lot to ponder in that short excerpt from a typical Living Medicine Institute training cohort. If you’re interested in this kind of teaching or training programs, feel free to reach out. We run a lot of cohorts, and if you’re someone who’s just listening in to pick up tidbits or useful pieces that you can use in your own cap practice, I hope this was valuable for you and gave you some things to think about. Like I said in the beginning, we’ll be continuing this kind of conversation. I’ll see you next time. 

Outro 31:11

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